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Healing Self Harm Scars

You may have heard the adage, “every face tells a story.” In truth, far more than just our faces tell stories. Our clothes, our hair, even our skin can teach people things about us, including some things we may not want them to know.

Imagine that you’re attending a company picnic in July. The temperature is in the mid-80s and everyone has been invited to “dress down.” So when you show up wearing a cardigan, you incur more than a few odd looks. Someone suggests you take the cardigan off. After all, you must be sweltering in long sleeves. Do you decline and leave people wondering, or do you take the cardigan off and invite even more questions?

Many people feel self-conscious about extensive scarring. That’s why so much effort and research has been poured into scar removal techniques. However, people whose scars are the result of deliberate self-injury find it particularly difficult to cope with their disfigurement. After all, it’s one thing to suffer people’s pity when they ask about a burn scar or gash from a car accident. It’s entirely another to have to suffer their judgement.

That’s what makes self-harm scars so debilitating: it’s not the scars themselves, but the constant worry that those scars act like a sign for the rest of the world — a big flashing billboard that advertises your history of depression, anxiety, or self-destructive tendencies.

It’s entirely possible that your friend, date, boss, or co-worker won’t care in the slightest about your scars. And why should they – that part of your life is hopefully behind you now. It’s difficult to assess the effect that your scars will have on your personal and/or professional life. What matters is that they’re upsetting to you and possibly preventing you from living a life free of the fear of judgement.

Fortunately, the medical community has pulled through and there are now a wide variety of scar removal and treatment options available. In this article, we’ll discuss finding the best option for you personally, and highlight some of the more popular methods being used to treat and hide self-inflicted scars.

Listen to Your Doctor, Not the Blogs

If you’ve been doing your research on self-harm scar removal, you’ve probably heard that techniques like dermabrasion and laser scar removal are ineffective against self-inflicted scars. You may have also read that significant scar revision or removal is impossible, and you have little choice but to resort to medical tattooing (a technique we’ll address in more detail later) in order to permanently disguise them.

It is true that dermabrasion is more useful for lighter scars, such as those resulting from acne or minor injuries, and does little to address the keloid or hypertrophic scars which tend to result from self-injury. However, remember that everyone’s scarring is going to be unique.

What procedure works best for you will depend on the size, amount, and location of your scars. Always consult with a plastic surgeon before writing off a technique or surgical treatment. You could find yourself pleasantly surprised.

The following techniques may or may not be right for you. However, they are among the latest and most popular methods, making them as good a place as any to start thinking about the new you.

Keloid Scars

RELATED: Keloid Scars: How to Treat a Wound That Doesn’t Know It Has Healed

Blend Your Scars with Medical Tattooing

When we talk about “tattooing,” we’re not talking about colorful sleeve tattoos to hide your scars (although some people do go that route). Instead we’re referring to the use of color in the skin to blend the scars in with your natural complexion.

Medical tattooing starts with microneedling, also known as Collagen Induction Therapy (CIT). This popular scar relaxation technique uses tiny needles that repeatedly puncture the skin. It’s kind of like getting a tattoo, except without any ink. The procedure is intended to induce collagen production, hence it’s name. As such it can reduce the appearance of scars, softening them up and blending them in with the skin.

Medical tattooing for scar revision, also known as micropigmentation, is basically microneedling with a little pigment added to the mix. The pigment is matched to your skin tone and injected into the scar tissue. This will in no way remove the scars, but it should make them less visible.

Micropigmentation doesn’t work overnight. Scars might appear red at first, making them more visible. However, with time the color fades and the scars blend in. It’s also sometimes necessary to have more than one session to ensure the best results. Luckily, recovery is easy and most people are able to resume their normal activities after no more than 24 hours.

medical tattoo arm
Before and after. Credits: R. Swissa

According to Beverly Hills-based permanent makeup artist Ruth Swissa, CMM, micropigmentation should only be performed by an experienced professional who understands how the skin’s undertones will blend with the tattoo pigment to achieve natural, long term results. This requires artistry and strong technical skills.

If you are considering medical tattooing to improve the appearance of your scars, make sure you that you deal with a Certified Medical Micropigmentation expert.

Use Fat Transplantation to Smooth Out Skin

This procedure is somewhat more intense, hence requiring a somewhat lengthier recovery period. However, if your scars are textured, especially if they are depressed, a fat transplant will smooth out your skin, making them less noticeable.

Fat transplants, also called fat transfers or fat grafting, are exactly what they sound like: fat is taken from one part of your body, processed and cleaned, and injected into another part of your body. In this case, the fat is injected into the scars. The result is usually fuller, smoother looking skin.

Because your own fat is being used there is little to no risk of an allergic reaction. However, the procedure is not without potential negative side effects. You may experience bruising, swelling, and bleeding. At worst, while unlikely, you could develop an infection or abscess.

The bruising may last for several days and the swelling several weeks after that. It’s difficult to pin down an exact recovery time for fat transplants, however, because your post-operative instructions and healing process will depend on the location and size of the injection sites.

fat grafting

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Surgically Remove the Scars from Your Body

If you think this sounds a little extreme, you’re not wrong. Although there are some variations in how this procedure is performed, the basic idea remains the same: the scars are treated with steroid injections before being removed entirely, along with a portion of surrounding and underlying skin. Skin is then harvested from another part of the body and grafted onto the affected area.

In a 2005 study published by the Journal of Plastic and Reconstructive Surgery, Dr. Cengiz Acikel, a professor of aesthetic plastic and reconstructive surgery who practices in Istanbul, Turkey, explains his innovative take on this technique. It involves the removal of the uppermost part of the scarred area as a whole, using a laser or a dermabrasion device. The raw surface is then covered with a thin (0.2 mm) skin patch harvested from the thigh region.

The animation below shows the results of this procedure (Credits: Dr. Cengiz Acikel).

This method may not be for the faint of heart, but could be just the ticket for someone with severe self-inflicted scarring. Over time scarring from the actual skin graft becomes significantly less noticeable than the dozens of smaller scars it replaced.

A 2012 study details how a group of patients who underwent a similar treatment benefited from its outcome:

“Scars were excised from the forearm en block, removing the majority of the affected area. Simultaneous use of a single layer skin substitute was used, covered by an autologous split-thickness skin graft. Negative pressure wound therapy was then applied immediately for 2 weeks after surgery. Results: The original scars were successfully converted to a socially and cosmetically acceptable appearance.”

Sometimes, doctors choose to use artificial skin grafts for this purpose. In one 2008 study, doctors evaluated the efficacy of Integra, a skin graft substitute made from cow collagen proteins and shark cartilage. Artificial skin grafts, of which Integra is the most widely used, reportedly result in less scarring after the fact. This might make them more appealing to those looking to rid themselves of the evidence of their self-harm. However, little is known about the long-term effects of this method, as it hasn’t been around as long as traditional skin grafting.

Skin grafting is also the most invasive of the procedures mentioned here, and comes with the lengthiest recovery time. Typically, a skin graft should be coddled for approximately 2-3 weeks. In other words, don’t bump, stretch, or scratch it. A bandage may need to be worn for half or more of this time.

It’s also best to avoid getting skin grafts wet until your doctor says otherwise, and important to note that, unless you’re using an artificial graft, a skin graft will leave you with two wounds: one where the skin was grafted, the other at the donor site. Both sites need to be well cared for and result in a certain degree of scarring.

It could take months for skin grafts to start looking their best. This is by no means a quick fix for those in need of scar revision. However, the results are long-lasting and will continue to look better with time.

Post operative Drepression

RELATED: Understanding and Preventing Postoperative Depression

Healing the Skin – Healing the Soul

When it comes to self-harm, there is more to consider than just the scarring. Those who still struggle with self-mutilation should seek help from a mental health professional to try and overcome this behavior. Reputable, board-certified plastic surgeons will not operate on individuals who are still self-harming and will likely insist that the scars be fully healed before performing many of these procedures.

That being said, healing the body is only one element of the overall process. While you shouldn’t be ashamed of your body as it is, you shouldn’t be ashamed to ask for help with your emotional issues either.

Ask a Cosmetic Doctor on Zwivel

Got a question about a cosmetic treatment? With over 2,000 doctor answers and counting, the Zwivel forum is the best place to get expert professional opinions.

Hundreds of questions have already been answered:

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About The Author

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I am a former teacher, current resident of Colorado, and new mom. When I’m not writing and chilling with my son, I’m gaming, watching movies, doing yoga, eating out, taking pictures, and harassing my cats. I love words.